The new NC Medicaid Mental Health Parity website provides information on NC Medicaid compliance with federal mental health parity requirements.
Topics Related to Medicaid Managed Care
NC Medicaid is providing updated information to providers about the federal prohibitions on certain providers.
Recent court rulings now require the North Carolina Department of Health and Human Services to reverse provider rate reductions and restore rates to their Sept. 30, 2025, levels.
NC Medicaid Managed Care plans may apply utilization edits and/or prior authorization criteria per the Food and Drug Administration label on drugs when the State has not established criteria and has not prohibited use of criteria.
NC Medicaid is providing updated information to providers about the federal prohibitions on certain providers.
Request to Move forms for members in the Children and Families Specialty Plan to move to a Behavioral Health I/DD Tailored Plan do not need to complete a Service-associated Request.
This guidance is based on the NC Immunization Program/Vaccines for Children guidelines.
This guidance is based on products approved by the FDA and recommended by the CDC Advisory Committee on Immunization Practices.
Wegovy and Zepbound for indications other than weight loss to be covered based on the indications and usage criteria published in the FDA label, pending updated clinical criteria.
The five-year cost of dispensing survey has been completed for North Carolina pharmacies.